File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14581724789).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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uch enormous growth. An enormous tumour causes suffering by its mere sizeand weight. It may damage other parts by its pressure,and thus indirectly endanger life. It raises the pressurewithin the belly, makes the return of blood from thelower extremities difficult, and thus may cause oedema oflegs; and even phlegmasia alba dolens has been reported.It throws strain on the heart, and may lead to cardiacdilatation and defeneration. When the stomach is full,the tumour may press upon it, and cause vomiting. Thetumour may hinder the descent of the diaphragm, andthus make the breath short. A big tumour prevents thepatient from taking exercise, and thus leads to degenera-tion of muscle. These consequences of great bulk not SOLID ABDOMINAL TUMOURS. 823 only call for ojjerative cure; unfortunately, they do more:they add to its risk. Fibroids fixed in the pelvis.—The foregoing paragraphdescribes consequences which may result from a big tumourfree to move within the belly. But the tumour may not
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Fig. 240.—Fibroid incarcerated in pelvic cavity. (After R. Barnes, from a specimenin the Museum of St. Georges Hospital.) be free to move; it may be fixed within the pelvis (Fig. 240).In that case a smaller tumour may give grave trouble.There are three ways in which uterine fibroids may becomefixed in the pelvis:—(1) A uterus containing a big enoughfibroid in its fundus may get retroverted and incarceratedunder the sacral promontory, just like a uterus that containsan ovum. (2) A patient whose uterus contains a fibroid maybecome the subject of perimetritis, and thus the fibroid befixed by adhesions. The perimetritis may or may not be 824 DISEASES OF WOMEN. caused by the fibroid. I shall subsequently examine theways in which fibroids cause perimetritis. (3) The fibroidmay begin low down in the uterine wall, and grow outwardsinto the broad ligament. Whatever be the reason why the tumour is in thepelvis, as it grows it more nearly fills the pelvic cavity,and at length may become so t

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